Attitudes and Experiences of Belgian Physicians Regarding Euthanasia Practice and the Euthanasia Law

Context. Since the legalization of euthanasia, physicians in Belgium may, under certain conditions, administer life-ending drugs at the explicit request of a patient. Objectives. To study the attitudes of Belgian physicians toward the use of life-ending drugs and euthanasia law, factors predicting attitudes, and factors predicting whether a physician has ever performed euthanasia. Methods. In 2009, we sent a questionnaire to a representative sample of 3006 Belgian physicians who, because of their specialty, were likely to be involved in the care of the dying. Results. Response rate was 34%. Ninety percent of physicians studied were accepting of euthanasia for terminal patients who had extreme uncontrollable pain/symptoms. Sixty-six percent agreed that the euthanasia law contributes to the carefulness of physicians' end-of-life behavior; 10% agreed that the law impedes the development of palliative care. Religious beliefs and geographic region were strong determinants of attitude. Training in palliative care did not influence attitudes regarding euthanasia, but trained physicians were less likely to agree that the euthanasia law impedes the development of palliative care than were nontrained physicians. One in five physicians had performed euthanasia; they were more likely to be nonreligious, older, specialist, trained in palliative care, and to have had more experience in treating the dying. Conclusion. Most physicians studied support euthanasia for terminal patients with extreme uncontrollable pain/symptoms and agree that euthanasia can be part of good end-of-life care. Although physicians had little involvement in the process of legalizing euthanasia, they now generally endorse the euthanasia law. J Pain Symptom Manage 2011; 41: 580-593. (C) 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.